California Licensed Compliance Consultant
Job Summary
Supporting Health Plan Risk Adjustment operations, the full-time California Licensed Compliance Consultant will manage government audit readiness, compliance oversight, and internal quality assurance reviews while working remotely.
Key responsibilities:
- Oversee compliance activities by partnering with stakeholders and analyzing regulations to ensure adherence to established standards
- Conduct coding validation and documentation reviews to maintain coding integrity and regulatory compliance
- Lead compliance reporting efforts by summarizing audit data and presenting key findings to management and stakeholders
Required qualifications:
- Minimum six (6) years of medical coding experience
- Minimum three (3) years of experience in a leadership role
- Bachelor's degree in Health Care Administration, Clinical, Law, Public Health, Business, or a related field with a minimum of eight (8) years in health care compliance or a directly related field
- Certified Coding Specialist, Certified Risk Adjustment Coder, or Certified Professional Coder certification
Complete Job Description
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